If you are experiencing suicidal thoughts and are not under professional care, the National Suicide Prevention Lifeline is available 24/7 at 800-273-8255. Please call 911 in the case of an emergency.
Obsessive compulsive disorder (OCD) is often diagnosed with depression or other mood disorders. When left untreated in the wake of other risk factors, it can worsen depression. One alarming result can be suicidal thoughts. [i] The below expands on suicidal thoughts to challenge misconceptions that deter people from treatment and to serve as a basis for comparison against suicidal obsessions, a product of OCD.
What are Suicidal Thoughts?
Suicidal thoughts are caused by mental disorders and occur more frequently than you think
Suicidal thoughts or ideation occur as a result of psychological disorders like depression in the presence of other risk factors.[ii] Mood disorders including depression can challenge a person’s ability to assess and solve problems, leading to destructive ways of coping up to suicidal behavior. [iii] [iv]
An international study on suicidal ideation spanning 17 countries reported a 9.2% lifetime prevalence rate for suicidal thoughts and a 2.7% lifetime prevalence for suicide attempts among the general population. [v]
Suicidal thoughts are accompanied by feelings of worthlessness, hopelessness, depression and other negative feelings like embarrassment or guilt. Feelings of hopelessness have most repeatedly been linked to suicidal thinking and actions. [vi]
Types of Suicidal Thoughts
Suicidal thoughts run the spectrum from passive in nature to more laden with intent.
- Passive suicidal thoughts do not present a specific mode or plan of action, but demonstrate a degree of desire or contemplation.
- “What if I were gone tomorrow?”
- “I wish I could just disappear”
- “I want to fall asleep and never wake up”
- Active suicidal thoughts identify a specific means or action plan for carrying out the suicide.
- “I want to run my car into the center divider”
- “I will swallow this bottle of pills before I got to bed”
Are all Suicidal Thoughts Dangerous?
You cannot rely on the content of suicidal thoughts alone to predict risk
Suicidal risk is a complicated topic that takes many factors into account.
A passive, “fleeting” suicidal thought may not seem troubling. Yet research has shown that the content of the thought alone is not a good indicator of risk. One study found that 1 in 3 patients who had attempted suicide only reported passive suicidal thoughts.[vii] Another study that examined 100 severe suicide attempts found that in 69% of the cases the patient reported no prior active ideation.[viii]
Physicians consider suicidal thoughts against a broader picture to determine risk level.
A person’s immediate life situation, demographic background (age, sex, gender, ethnicity), personality, thinking and coping styles, psychological and medical history all compute into the risk factor for suicide attempts. [ix] [x]
Those who are female, single, unemployed and fall into either extreme of the age spectrum (15-35 or 75+ years) represent a high risk demographic. [xi] [xii] People who have existing mental disorders or substance abuse problems also present an elevated risk. [xiii] Finally, those who suffer from debilitating or potentially fatal chronic conditions like terminal cancer or HIV/AIDS are a risk group. [xiv]
Recent life struggles including job loss, friendship difficulties, or rejection in the presence of other risk factors may be a tipping point into suicidal thinking or behaviors. Although fault is often placed on these isolated life events, the culmination of the above risk factors are actually to blame. [xviii]
Even in the wake of a high risk profile, certain resiliency factors may render suicidal behavior unlikely. Examples include strong religious beliefs denouncing suicidal behavior, well-developed coping skills, and strong social networks.[xix] [xx]
Rumination describes obsessive focus over negative consequences of past events
Rumination describes the habit of mulling over feelings and consequences as they relate to past events. [xxi] It is a destructive coping mechanism with an obsessive focus on the source and anticipated consequences of distress as opposed to potential solutions. It has been identified as a risk factor for suicidal thoughts separate from its role in helping ignite and worsen depression. [xxii]
Rumination deserves special attention because it appears in many other mood and anxiety disorders. In relation to depression and suicidal risk, ruminative thoughts are centered on past events (unlike Generalized Anxiety Disorder) and their possible outcome, not so much the content of the thoughts (Obsessive Compulsive Disorder).
The Common Denominator
Suicidal ideation is accompanied by ambivalence
A central feature in cases of suicidal thinking is an ambivalent attitude towards life or death. [xxiii] A person may gravitate in either direction at a given point depending on the presence and relative strength of risk vs. resiliency factors. This oscillating effect has been documented as sudden and intense, further underscoring the importance of proactive treatment.
The above is not intended to overwhelm with information or anxiety.
It was designed to clear misconceptions about suicidal thoughts and drive home the importance of seeking professional treatment no matter how harmless the thoughts seem.
For those with Obsessive Compulsive Disorder of the self-harm variety, this article serves a special purpose — to demonstrate that in the quest for certainty, we invariably create more questions than answers. That in our compulsive ways driven by distorted thinking, we deny this fact of the human condition, leaving us shackled from all its splendor — overwhelmed with anxiety and fear. Yet, the key is always in our reach.